Is it safe to teach a woman in your prenatal class with Placenta Previa?
Experienced prenatal yoga teacher and Bliss Baby Yoga’s new Content Advisor, Nadine O’Mara, explores this question.
What is Placenta previa?
The placenta is a key organ for pregnancy, attached to the baby via its umbilical cord, and provides oxygen and nutrients for the baby. Ordinarily, the placenta is attached to the wall of the uterus but in a condition called Placenta Previa it can be located lower down the uterus, obstructing the cervix (entrance to the womb). This obstruction can cause potential serious complications in late pregnancy and during birth.
Placenta Previa is actually a very common occurrence for many women in early pregnancy and if it’s detected by ultrasound it can cause needless concern for many women. This is due to the fact that for 19 out of 20 women, the placenta will move out of the way as the uterus grows and the pregnancy progresses.
I once had it explained to me like this: imagine drawing a large spot on a balloon that is only partially filled. As you blow the balloon up to full size, the spot will have moved from its original position significantly, moving up and away from the opening of the balloon. The uterus and placenta behave in a similar way as baby grows.
In the majority of cases, the placenta will have moved out of the way by the third trimester (late pregnancy), which means that only 1 in 200 women will still have Placenta Previa by this time.
It is even more rare that the placenta completely covers the opening of the uterus—often the covering is only partial, which means it has a greater chance of moving out of the way during pregnancy.
There are four gradings of previa:
- Grade I— low lying: the placenta is lying close to, but not covering, the cervical opening
- Grade II—marginal: the placenta is at the edge of the cervical opening but does not cover it
- Grade III—partial: the placenta partially covers the cervical opening
- Grade IV—full: the placenta fully covers the cervical opening
Yoga for Placenta Previa
So how do you support women who come to your prenatal yoga class with this diagnosis? These women may be feeling quite nervous and may have been told they should be on bed rest.
Bliss Baby Yoga Director, Ana Davis, recommends that firstly it’s important to check as to the advice of the woman’s OB/midwife and to find out if it’s a full or partial covering.
Full Placenta Previa
For a full Placenta Previa, a woman should avoid doing yoga asana (postures). Instead, practices such as Yoga Nidra, and visualizing the placenta moving out of the way, can be very powerful. Registered midwife and yoga teacher, Erin Mieszko, agrees that the non-physical aspects of yoga can be very beneficial for these women. Erin says that the anxiety of feeling like a “time bomb” and the immobility of bed-rest can increase the risk of conditions like diabetes and blood clots. “Yoga is so very versatile and can be made safe for all,” she reassures.
Partial Placenta Previa
If it’s a partial or marginal Previa, and the woman is midway through her pregnancy, she can practise in class but the teacher needs to work with her carefully.
To accommodate these mamas we need to avoid or modify poses that create pelvic compression.
Avoid wide legged poses such as the Bliss Baby Classical Women’s Group 1 postures (wide-legged, hip and groin opening postures), and squatting. Bringing the feet closer together and not bending the knees as deeply in the Warrior poses (Virabhadrasana I and II) or Side Angle pose (Parsvakonasana) will help protect the pelvic area. I often have students do Trikonasana (Triangle Pose) with legs closer together instead of the Warrior poses.
While squats during pregnancy are highly beneficial in helping open the pelvis and hips, it can be a good idea to avoid unsupported squats in any pregnancy class as some placenta previas are not yet diagnosed. Deep unsupported squats such as Malasana put pressure on the cervical opening. Instead, always have your students use two or three blocks under their buttocks so that they are essentially sitting in the squat (pictured).
Avoid Malasana altogether in cases of Previa, and instead, have mamas sit on a folded blanket with knees parted and bent – this still helps open the hips without placing undue pressure on the cervix (pictured).
Baddhakonasa (seated groin stretch/ Butterly pose) is also best to be avoided. Alternatively, have women take an easy Cross Legged pose while sitting on a blanket.
Chairs can be beneficial for any pregnancy yoga practice but even more so in supporting Previa as the opening to the womb is supported. Please see the chair sequence below that can be used for any pregnancy yoga class but is particularly suitable for women with low lying placentas.
It can be helpful to remember that the adjustments for Placenta Previa are very similar to those with pelvic instability. And it’s important to check as to the grading of the previa and if the mama has the approval of her caregiver to practice. If you have the all-clear, it can help to show her some of the modifications before the class begins.
Yoga can be so beneficial for these women, whether it’s for its soothing relaxation practices, or as a physical practice; we just need to give them a little extra attention.
- Sarah Buckley www.sarahbuckley.com
- Prenatal Yoga Centre www.prenatalyogacenter.com
- Women and Children’s Health Network www.cyh.com
Chair yoga sequence for Placenta Previa
Begin by sitting on the chair knees a little wider than hip width distance. Imagine you are steering a big ship, holding the helm, or wheel, in your hands taking it from side to side x 10
Coming back to centre, knees hip width distance in your seat. Inhale and place your right elbow on the back of the chair, left hand to opposite knee. Exhale and turn to your right leading with your heart, rather than your neck. Use your breath to turn a little deeper. Repeat to the other side.
Seated Eagle (Garudasana)
Place your right leg over the left and your right arm under your left arm to bring the palms together. Lift the elbows away from your heart centre.
Seated Warrior II (Virabhadrasana II)
Slide your hips to the back of the chair and bend your right knee, foot facing forward. Bend your left leg in front of you and extend your arms so you are in a seated modified Virabhadrasana II pose, your dristhi on your middle right finger. Hold for 3 breaths.
Supported Side Angle (Parsvakonasana)
Keep your legs where they are and bring your right elbow to your knee. Take your left arm over into a supported Side Angle pose Parsvakonasana. Hold for 3 breaths and then repeat 3 & 4 to the other side.
Standing Supported Side Stretch
Come to standing and have the chair back to your right. Place your right knee on the chair and turn your left foot so that it is parallel to the seat. Bring right hand to the chair and extend the left arm over your head and to your right. Hold for 3 breaths and then repeat to the other side, turning the chair so that the back is then on your left.
Seated Supported Forward Fold
Sit back on the chair knees just beyond hip width distance and bring your elbows onto the chair and lean forward. Take 3 long slow breaths imagining you a drawing air up through your pelvis into your belly, like a golden light filling your belly and exhaling the breath back down for the same count.
Finish your practice seated up right on the chair and spend a few minutes visualise your placenta moving up and away from the opening of your cervix. Childbirth Educator and Bliss Baby Yoga guest teacher, Anna Watts, also suggests observing any fears that may come up surrounding giving birth to baby vaginally. The mind can be very powerful in so many ways but especially when it comes to birthing our babies.
If you would like to expand your knowledge in teaching yoga for mums-to-be safely and confidently, you may be interested in our Bliss Baby Yoga Online Prenatal & Postnatal Yoga Teacher Training course, and Online Extension Modules covering topics including Prenatal & Postnatal Anatomy and Physiology and Pelvic Floor Anatomy and Physiology for Women’s Health. We offer a holistic approach to teaching Prenatal and Postnatal Yoga, with a focus on safety guidelines and contraindications for safe and appropriate practices to nourish prenatal students and new mothers.
Nadine O’Mara is an experienced prenatal and postnatal yoga teacher, doula, and our Bliss Baby Yoga Co-Director and Online Course Content Manager, who also runs her own business, Conscious Birth. Nadine shares her wealth of knowledge through contributing and editing content for our Bliss Baby Yoga online courses and social media, including being a co-facilitator of our Online Level 2 Fertility Yoga Teacher Training course. Nadine provides doula support, birth education and yoga for women and their partners in and around Bellingen on NSW’s mid north coast, as well as offering self care and restorative yoga workshops.
Illustrations by Sophie Duncan www.deerdaisy.com
Further Reading related to this topic:
- Chanting, Mantra and Mudra for Pregnancy and Birth by Jennifer Allen
- Healing the wound: How can we best support mothers after caesarian? by Nadine O’Mara
- Let’s Twist Again! Twisting safely during Pregnancy by Ana Davis
- To supine or not to supine, that is the question! by Ana Davis
- Releasing the Psoas during Pregnancy by Ana Davis